Permanent Transvenous Pacemaker Implantation in Forty Dogs

Abstract

Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications. (Journal of Veterinary Internal Medicine 1991; 5:322-331) THE FIRST totally implantable artificial cardiac pacemakers were developed more than 30 years ago.' Since then, the equipment and techniques available to accomplish artificial cardiac pacing have changed dramatially.^-^ One of the most important technologic advances in artificial pacemaker design has been the development of durable pacing and sensing endocardial electrodes (leads) that can be introduced into the heart from a peripheral vein6-* Before the development of permanent transvenous leads, reliable artificial cardiac pacing could only be accomplished by surgical implantation of an epimyocardial electrode. Currently, transvenous

Complication Rates Associated with Transvenous Pacemaker Implantation in Dogs with High‐Grade Atrioventricular Block Performed During versus After Normal Business Hours

“…Transvenous pacemaker implantation, performed using a jugular venotomy with the pacing lead placed into the right ventricle under fluoroscopic guidance, generally is considered the preferred method of pacemaker placement in dogs 3, 4, 5…”

“…Several large‐scale retrospective studies2, 3, 4, 5, 7 have reviewed the outcomes and complication rates associated with PAP placement in dogs. Rates of major complications ranged from 55 to 71% in the 1980s8, 9 but have decreased to 13–33% in the 2000s 2, 3, 4, 7.…”

Implantation of Permanent Transvenous Endocardial Pacemaker in a Dog with Atrioventricular Block

“…65(10): 1131-1134, 2003 Implantation of artificial cardiac pacemaker is commonly used in humans for the treatment with bradyarrhythmias. In small animals, as well as in humans, pacemaker therapy has been used for the naturally occurring bradyarrhythmias, including sick sinus syndrome, persistent atrial standstill, and complete or advanced second-degree atrioventricular (AV) block [5,6]. Although reports in humans are quite extensive of pacemaker therapy, there are limited studied on the use of pacemakers in small animal practice.…”

“…Surgical techniques for permanent pacemaker implantation were reported previously as epicardial [1,4] or endocardial [5,6] implantation, each having distinct advantages and disadvantages. Endocardial implantation through the jugular vein has been more commonly used because it is a less invasive procedure, can be performed more rapidly, and results in lesser complications than epicardial implantation which requires a thoracotomy or celiotomy [5].…”

Successful Use of an Acceleration Rate Response Pacemaker with a Transvenous Steroid-Eluting Screw-in Lead for Third-Degree Atrioventricular Block in a Labrador Retriever

“…However, there are still many complications encountered with pacemaker use [4,6,10,13,15,16]. Lead dislodgement is one of the major problems [14,18]. In human medicine, a steroid-eluting screw-in type lead has been developed that is less invasive, yet can be anchored more effectively to the myocardial wall [9].…”